Seeing your child in pain: Parent empathy in the context of their child's chronic pain

Observing your child in pain is inherently distressing. In the context of chronic pain, caregiver responses can powerfully impact child pain-related functioning. The Parent Empathy in the Context of Pain model postulates that parent empathic distress may hinder adaptive responses to child pain, thus playing a key role in the link between parent responses and child functioning. Here, we examined how parent empathy is related to parent and child pain-related constructs within the Parent Empathy in the Context of Pain model, using an adapted Empathy for Pain Scale (EPS) for use in parents (P-EPS). Data were collected from 190 parents of youth with chronic pain (170 mothers; children aged 8-18y) and their children. Structural equation modeling (SEM) showed support for the theoretical model. Parent pain-related beliefs were associated with behavioral responses via affective responses of empathy for pain (affective distress) and emotion regulation (emotional suppression), which in turn were associated with child pain-related functioning. Moreover, higher levels of parent empathic distress to observing their child's pain was significantly associated with more general empathic distress, poorer perspective taking and more maladaptive emotion regulation strategy use (emotional suppression). Our findings underscore the involvement of parent affective responses in driving parent maladaptive behavioral responses to their child's pain and emphasize the role of affective empathic distress as well as its regulation. In addition to providing information on its assessment, this empirical investigation provides novel insights into the construct of empathy in this context. PERSPECTIVE: This article presents initial data supporting the Parent Empathy in the Context of Pain model. Findings show involvement of parent affective responses in driving parent maladaptive behavioral responses to their child's chronic pain and emphasize the role of affective empathic distress as well as its regulation.